Life-changing support through a holistic approach
How a team of caregivers considered needs beyond medicine to “ramp up” support for a HealthSelect participant
For some people dealing with a serious or chronic medical condition, it can be a struggle just to get through the day, let alone manage their health concerns and figure out the health care system. Fortunately, if you’re in a HealthSelect of Texas® medical plan, you don’t have to do it on your own.
If you have an upcoming surgery or are recovering from a recent procedure, or if you were recently diagnosed with a condition, a caring team of Texas-based nurses, social workers and mental health professionals are here to support you and your covered family members through it all.
Blue Cross and Blue Shield of Texas (BCBSTX) care management clinicians regularly reach out to HealthSelectSM participants with chronic or serious health concerns to provide support and answer questions. Care management teams take a holistic approach, which means they consider a spectrum of issues—not just strictly medical needs—that a participant might experience. They can talk with you about things like managing a health condition, understanding a procedure or hospital stay, and following your therapist’s or physician’s treatment plan. They may also start conversations about non-medical issues that could be affecting your overall health and, if needed, refer you to support resources within your community.
Here is a real-life situation showing the positive difference the care management team can make. To protect the personal health information of this participant, we are not using real names in this story.
Victoria, a BCBSTX clinician, reached out to John, a HealthSelect participant in treatment for a serious condition. Victoria made a care plan with John to identify any care needs. She scheduled regular calls to make sure he was able to get to his medical appointments and get his medications, and that he had the emotional care and support he needed.
During one of their conversations, Victoria asked John about his financial situation. John shared that he was struggling to keep up with his medical bills and other expenses. This prompted Victoria to connect John with Julie, a social worker on the care management team.
Julie talked with John to see how she could help. She was able to provide a list of resources in his community that might be able to help with some of his expenses. She continued talking with him to learn what else he might need.
One key question Julie asked was if John felt safe in his home. He shared that with his health issues, he was having mobility problems that made it difficult to get in and out of his home. Julie thought of the Texas Ramp Project, a non-profit organization that builds custom ramps for qualified individuals at no cost. She not only connected John to the organization, but helped him complete the application for a ramp at his home.
The Texas Ramp Project approved John’s application, and volunteers built him a custom ramp. They even left additional lumber so John could repair some steps that needed work.
John told Julie how grateful and excited he was with this life-changing gift. He could now get in and out of his home much more easily.
For her part, Julie is happy to have made a difference in a way that helps John every day. “Helping John has been one of the highlights of my social work career,” she said. “It’s what social work is all about, making a real difference in the lives of others. And the opportunity to work with a great team that meets the needs of our participants in so many ways makes me proud to be a part of the Blue Cross and Blue Shield of Texas care management team.”
Victoria and Julie continue to support John as he recovers. Julie follows up every couple of weeks to make sure his recovery is progressing and to identify any new needs he might have—like emotional support or access to other resources in his community. Through their ongoing relationship, she was able to connect John to a mental health clinician on the care management team, for emotional support as he navigates his complex care needs.
A team of dedicated professionals to support you
Under the holistic approach, BCBSTX’s care management teams include a variety of professionals to help across a range of needs and issues.
Clinicians help people with all types of questions about many health issues including asthma, cancer, diabetes, heart disease, high blood pressure and musculoskeletal conditions. They can assist in finding health care providers and follow up to help you stick with your provider’s treatment plan. Mental health clinicians are available to address concerns about substance use, anger management, anxiety, depression, domestic violence, grief, post-traumatic stress disorder and stress.
Social workers can help you overcome barriers to getting the care and support you need. They work with you to identify emotional, financial and social issues that may make it harder to do your daily activities. Social workers may suggest resources such as local agencies that might offer financial support, transportation to medical visits, food, medication coupons, grants for certain treatments, and local or national support groups for specific conditions.
Care management is available to HealthSelect medical plan participants, including those Consumer Directed HealthSelectSM, at no out-of-pocket cost. If you get a call from a care management clinician, take the call, or call them back. You can also contact a care management team member by calling the number on the back of your ID card. Rest assured that BCBSTX will keep your health information private. If a clinician leaves a message for you, they will not say anything about your condition.
If you have questions for a clinician about a physical or mental health concern or condition or need additional support, you can reach out to the BCBSTX care management team. Just call toll-free (800) 252-8039 (TTY:711) between 8 a.m. and 6:30 p.m. CT Monday – Friday and ask to speak with a clinician.